[Preoperative evaluation of hemorrhagic risk]

Should we consider that haemostasis tests may help guide the anaesthesiologist's therapeutic choices when the patients is on the operating table and bleeds without evident explanation? The response is yes, provided that the results will be available rapidly. Haemostasis tests that are performed in laboratory wards distant from the surgery room often prove to be unuseful in emergency situations as haemostasis abnormalities usually occur in a shorter time than is required to get biological test results. Devices located in the vicinity of the surgery room should therefore be available to the anaesthesiologist. Furthermore, these devices should be able to perform not only platelet counts and haematocrit determination, but other blood tests that may be useful to get further insights in the patient's haemostasis function. Such devices are already available, allowing rapid haemostasis tests in the surgery room and prompt decision with regard to appropriate transfusion policy. However, the haemostasis laboratory is still useful, as it permits to refine coagulation profile and also offers quality controls for those tests that were done in the surgery room.